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Body mass index and colorectal cancer prognosis: a systematic review and meta-analysis.

Abstract

Colorectal cancer is one of the most common cancers worldwide. However, it is unclear what influence body mass index (BMI) has on colorectal cancer prognosis. We conducted a systematic review and meta-analysis of observational studies to examine the association of BMI with colorectal cancer outcomes. We searched MEDLINE and EMBASE databases from inception to February 2015 and references of identified articles. We selected observational studies that reported all-cause mortality, colorectal cancer-specific mortality, recurrence and disease-free survival according to BMI category. Random-effects meta-analyses were conducted to combine estimates. We included 18 observational studies. Obese patients had an increased risk of all-cause mortality [relative risk (RR) 1.14; 95 % confidence interval (CI) 1.07-1.21], cancer-specific mortality (RR 1.14; 95 % CI 1.05-1.24), recurrence (RR 1.07; 95 % CI 1.02-1.13) and worse disease-free survival (RR 1.07; 95 % CI 1.01-1.13). Underweight patients also had an increased risk of all-cause mortality (RR 1.43; 95 % CI 1.26-1.62), cancer-specific mortality (RR 1.50; 95 % CI 1.20-1.87), recurrence (RR 1.13; 95 % CI 1.05-1.21) and worse disease-free survival (RR 1.27; 95 % CI 1.13-1.43). Overweight patients had no increased risk for any of the outcomes studied. Both obese and underweight patients with colorectal cancer have an increased risk of all-cause mortality, cancer-specific mortality, disease recurrence and worse disease-free survival compared to normal weight patients.

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  • Authors+Show Affiliations

    ,

    Department of Surgery and Anaesthesia, University of Nottingham, Derby, UK.

    ,

    Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.

    ,

    Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.

    ,

    Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.

    Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA. gagliarg@yahoo.com.

    Source

    Techniques in coloproctology 20:8 2016 Aug pg 517-35

    MeSH

    Body Mass Index
    Cause of Death
    Colorectal Neoplasms
    Disease-Free Survival
    Humans
    Neoplasm Recurrence, Local
    Obesity
    Observational Studies as Topic
    Survival Rate
    Thinness

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    27343117

    Citation

    Doleman, B, et al. "Body Mass Index and Colorectal Cancer Prognosis: a Systematic Review and Meta-analysis." Techniques in Coloproctology, vol. 20, no. 8, 2016, pp. 517-35.
    Doleman B, Mills KT, Lim S, et al. Body mass index and colorectal cancer prognosis: a systematic review and meta-analysis. Tech Coloproctol. 2016;20(8):517-35.
    Doleman, B., Mills, K. T., Lim, S., Zelhart, M. D., & Gagliardi, G. (2016). Body mass index and colorectal cancer prognosis: a systematic review and meta-analysis. Techniques in Coloproctology, 20(8), pp. 517-35. doi:10.1007/s10151-016-1498-3.
    Doleman B, et al. Body Mass Index and Colorectal Cancer Prognosis: a Systematic Review and Meta-analysis. Tech Coloproctol. 2016;20(8):517-35. PubMed PMID: 27343117.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Body mass index and colorectal cancer prognosis: a systematic review and meta-analysis. AU - Doleman,B, AU - Mills,K T, AU - Lim,S, AU - Zelhart,M D, AU - Gagliardi,G, Y1 - 2016/06/24/ PY - 2016/05/15/received PY - 2016/05/18/accepted PY - 2016/6/26/entrez PY - 2016/6/28/pubmed PY - 2017/9/22/medline KW - BMI KW - Body weight KW - Colorectal cancer KW - Mortality KW - Obesity KW - Systematic review SP - 517 EP - 35 JF - Techniques in coloproctology JO - Tech Coloproctol VL - 20 IS - 8 N2 - Colorectal cancer is one of the most common cancers worldwide. However, it is unclear what influence body mass index (BMI) has on colorectal cancer prognosis. We conducted a systematic review and meta-analysis of observational studies to examine the association of BMI with colorectal cancer outcomes. We searched MEDLINE and EMBASE databases from inception to February 2015 and references of identified articles. We selected observational studies that reported all-cause mortality, colorectal cancer-specific mortality, recurrence and disease-free survival according to BMI category. Random-effects meta-analyses were conducted to combine estimates. We included 18 observational studies. Obese patients had an increased risk of all-cause mortality [relative risk (RR) 1.14; 95 % confidence interval (CI) 1.07-1.21], cancer-specific mortality (RR 1.14; 95 % CI 1.05-1.24), recurrence (RR 1.07; 95 % CI 1.02-1.13) and worse disease-free survival (RR 1.07; 95 % CI 1.01-1.13). Underweight patients also had an increased risk of all-cause mortality (RR 1.43; 95 % CI 1.26-1.62), cancer-specific mortality (RR 1.50; 95 % CI 1.20-1.87), recurrence (RR 1.13; 95 % CI 1.05-1.21) and worse disease-free survival (RR 1.27; 95 % CI 1.13-1.43). Overweight patients had no increased risk for any of the outcomes studied. Both obese and underweight patients with colorectal cancer have an increased risk of all-cause mortality, cancer-specific mortality, disease recurrence and worse disease-free survival compared to normal weight patients. SN - 1128-045X UR - https://www.unboundmedicine.com/medline/citation/27343117/full_citation L2 - https://dx.doi.org/10.1007/s10151-016-1498-3 DB - PRIME DP - Unbound Medicine ER -